Student Name *

Applying for:
Charter School
Early Childhood South Campus
Early Childhood North Campus

Additional fees may be required to complete this process for Early Childhood programs. Please review our Tuition and Payment Plans page first and then contact the IVMS Charter office if you have further questions.

Sibling Name (if already attending IVMS)

Please select grade level from one campus only:
Must be age 5 by Sept 1 to start Kindergarten

South Campus Grade LevelEarly ChildhoodKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th - Middle7th - Middle8th - Middle
            OR
North Campus Grade LevelEarly ChildhoodKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade

School Year *  School Year2010-20112011-20122012-2013  

Date of Birth *   MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Day01020304050607080910111213141516171819202122232425262728293031 Year 199119921993199419951996199719981999200020012002200320042005200620072008 2009

Birth Place
  GenderMaleFemale

Home Street Address *

Village, Town or City *

County*

State or Province *
AlabamaAlaskaAlbertaArizonaArkansasBritish ColumbiaCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineManitobaMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew BrunswickNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOntarioOregonPennsylvaniaPuerto RicoRhode IslandSaskatchewanSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming

Zip Code *

Phone Number *

Email Address *

IEP (Individual Education Plan) Required? yes no  

If yes, please specify:
Speech/Language
Specific Learning Disability
Gifted
Occupational Therapy
Other:

Previous Education:
Previous SchoolMontessori SchoolPrivate SchoolFlorida Public SchoolOther Public SchoolNone  

If your child has previous Montessori experience, please describe in detail below:

Comments

Additional Comments:
Please tell us anything you think we may need to know about your child or his/her previous school and educational experiences

Comments

Mother's Information

Mother's Name

Occupation

Employer

Home Phone Number

Work Phone Number

Cellular Phone Number

Father's Information

Father's Name

Occupation

Employer

Home Phone Number

Work Phone Number

Cellular Phone Number